Scott’s conversion came one week after Election Day, when Florida voters supported Obama’s re-election and struck down a constitutional amendment aimed at making it harder to implement the health law. Governors in just 13 states committed before the election to building their own insurance exchanges, which the law requires to provide medical coverage to the uninsured. If states fail to act, the federal government will create them.

While states have until Dec. 14 to say whether they plan to build their own marketplaces, hospital chains like HCA Holdings Inc. and insurers including UnitedHealth Group Inc., the biggest private provider of health benefits, have spent millions on technology, marketing and planning to prepare.

Helping Hospitals

Obama’s re-election rallied shares of hospital chains, including HCA, where Scott was once chief executive officer, on prospects for millions of newly insured patients being added to their rolls. UnitedHealth, WellPoint Inc. and other insurers declined as the industry faced profit limits and new taxes to help pay for the coverage expansion.

At Scott’s direction, Florida was the second-most-populous state to oppose changes under the Patient Protection & Affordable Care Act, including an option to expand Medicaid eligibility. Nearly 20 percent of Florida’s 19 million residents didn’t have health insurance in 2011, a rate surpassed only by Texas, Nevada and Louisiana, Census data show.

Scott founded and financed the nonprofit Conservatives for Patients Rights in 2009 to oppose Obama’s health-insurance changes. In April 2010, one month after Obama signed the changes into law, Scott announced his candidacy for governor, the first office he sought, and spent $73 million of his own on the race.

Coining Words

As governor, Scott has opposed much of Obama’s policy, using terms including “Obamacare,” “Obamacrats,” “Obama math” and “Obama rail” to describe the president’s agenda.